Rotator Cuff Pain
The rotator cuff consists of muscles and tendons surrounding the shoulder joint. Tendons are tough tissues linking muscles and bones. The function of the rotator cuff is to maintain shoulder stability and function. However, rotator cuff pain and injury can occur suddenly or develop gradually from joint wear and tear.
Types of Rotator Cuff Injuries
The common types of rotator cuff injuries are:
- Rotator cuff tear – This occurs when one or more muscles or tendons in the rotator cuff tear. Tears can be partial or complete. They may happen abruptly due to an injury or develop slowly over time.
- Tendinopathy – Tendinopathy refers to various tendon issues in the shoulder. Tendons may be stuck between the upper arm bone and shoulder blade, a condition known as subacromial or shoulder impingement. Over time, the tendon may tear.
Symptoms
The primary sign of rotator cuff damage is pain in the upper and side areas of the shoulder. It may be a dull ache or a sharp, sudden pain if caused by an accident. At times, the pain extends toward the elbow.
Shoulder pain usually worsens when lifting your arm or reaching overhead. It can also be more intense at night, particularly if you sleep on the affected side, which may disrupt sleep and cause fatigue.
Other symptoms include:
- Weakness when lifting or moving your arm
- Limited shoulder movement
- Clicking or grating sounds when moving the shoulder
Causes
Many cases of rotator cuff problems develop gradually with age as wear and tear on the shoulder increases. Tendons also lose their ability to repair over time.
Repetitive overhead movements raise the risk of injury and pain. In addition, activities like throwing, weightlifting, painting, and front crawl swimming can strain the rotator cuff.
An acute or sudden injury, such as a fall or accident, can also result in a rotator cuff tear.
Diagnosis
A clinician can usually diagnose a rotator cuff injury by assessing your symptoms and conducting an examination of your shoulder. They will ask about past injuries and activities that worsen the pain. You may also be asked to perform specific movements to evaluate shoulder function.
In some cases, you may be referred to a specialist for further evaluation. They might suggest imaging tests to assess the damage and create a treatment plan. These may include an X-ray, MRI scan, or ultrasound scan.
Treatment Options
The best treatment for rotator cuff pain and damage depends on factors like injury type, severity, age, and activity level. Some cases require surgery, as rotator cuff tears don’t heal on their own. However, non-surgical treatments can ease pain and strengthen the shoulder, and many people recover without surgery. Your GP will discuss the best approach for you.
Self-care remedies:
- Rest your shoulder and avoid lifting heavy objects or overhead movements. Once the condition improves, you can slowly begin increasing your shoulder activities.
- Use an ice pack wrapped in a towel to ease pain and reduce swelling. Avoid direct contact with the skin since it can lead to damage or burn.
- Take over-the-counter pain relievers like ibuprofen or paracetamol as needed.
Physiotherapy:
Your doctor may refer you to a physiotherapist who will guide you through stretches and exercises to improve shoulder strength and mobility. Treatment usually lasts up to six weeks, with many people recovering within this period.
Steroid injections:
If pain persists, your doctor may recommend a steroid injection to reduce swelling and discomfort. This also makes physiotherapy easier since symptoms will be minimal. Nonetheless, these injections have potential side effects, which your doctor will discuss with you.
Surgery:
Surgery may be needed for tears from sudden injuries or long-term damage that doesn’t improve with other treatments. Options include:
- Open surgery – Used for large tears, requiring a single large incision.
- Keyhole surgery (arthroscopy) – Minimally invasive, using small incisions and specialised tools.
- Mini-open repair – A combination of keyhole surgery and a small incision.
Recovery from surgery requires a rehabilitation program to restore shoulder strength and movement. Full recovery can take 6 months or longer, but adhering to the rehab guidance increases the odds of success in the long run.
Don’t let pain hold you back! Schedule an appointment today to discuss the best treatment options for your rotator cuff injury.